Title : Functional outcomes of DSSA-Based pelvic rehabilitation combined with manual therapy and Electrostimulation in men after oncologic surgery: A retrospective case series
Abstract:
Objective: Pelvic floor dysfunction, pain, impaired muscle control, and reduced quality of life are common consequences following oncologic surgeries such as rectal and testicular cancer procedures in men. This retrospective case series aimed to investigate the effects of a DSSA-based pelvic rehabilitation program combined with manual therapy and electrostimulation on functional recovery outcomes.
Methods: Two male patients with pelvic floor dysfunction following oncologic surgery (rectal and testicular cancer) treated at Fizyomen Physiotherapy Clinic, Izmir (2024–2025) were retrospectively analyzed. The treatment protocol consisted of manual therapy (internal–external pelvic release, abdominal fascial mobilization, sacral relaxation), DSSA-based postural alignment and core activation, rectal-probe-assisted EMS, diaphragmatic–pelvic breathing synchronization, and home-based relaxation/awareness exercises. Outcome measures included VAS, ICIQ-UI SF, Wexner Score, Oxford Muscle Scale, PFDI-20 and clinical observations.
Results: Both patients demonstrated ≈70% pain reduction, improved pelvic muscle strength (Oxford 2 → 4), and significant improvement in continence, abdominal relaxation, and breathing coordination. Mean ICIQ-UI SF decreased 18 → 7; Wexner 12 → 3. No adverse effects were reported.
Conclusion: The combination of DSSA and manual therapy appears to be an effective approach for pelvic floor rehabilitation following oncologic surgery. This model promotes muscle-tone balance, restores fascial flexibility, and enhances functional control, emphasizing the importance of multidisciplinary physiotherapy in oncologic rehabilitation.
